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Verma's confirmation comes as congressional Republicans advance their efforts this week to repeal and replace Obamacare, an overhaul that would entail great involvement from CMS. The health care bill making its way through the House currently plans to eliminate Medicaid expansion after 2020.

An ally of Vice President Mike Pence, Verma has been working on health care policy for more than a decade and developed an alternative Medicaid plan in Indiana -- under former Republican Gov. Mitch Daniels -- that won plaudits from conservatives.

When Obamacare became law, Verma helped Pence, then the Indiana governor, tweak the Healthy Indiana Plan, sell it to the Obama administration as the vehicle for Medicaid expansion, and then dramatically scale it upward. It became a program Pence championed as a conservative alternative to Obamacare's main vehicle for expanded coverage.